New level of transparency in healthcare: ABC 7 News

Beginning January 1, 2021, hospitals were required by federal regulation to post their prices and negotiated reimbursements from third-party payors online for patients/consumers to access. The Centers of Medicare/Medicaid (CMS) stipulated hospitals must post pricing and reimbursement amounts for 300 healthcare services, 70 of which are mandated by CMS.

Employers who sponsor health plans for employees would be wise to take advantage of this new rule. The lack of transparency in healthcare pricing/reimbursement has long been a significant impediment to employers looking to curb their healthcare costs. Now, when utilized strategically, employers will be able to more accurately benchmark their own plans against other “payors” in the market. They will also gain more insight into the true “cost” of healthcare, not just the “price”.

Yet, most employers are unaware that this new CMS rule exists, much less how to leverage and use the new information that is available. The keys to reducing healthcare costs rest in awareness, data, and a willingness to act on information gleaned from things like increased transparency. And if you think your “carriers” are already doing this for you, think again. They passionately oppose these types of transparency rules, and when you dig into the data, you begin to understand why.

If you would like to know more about how your organization can access, decipher, and leverage your health plan’s data, give us a call.

I sat down with David Furtado with ABC 7 News and had a great conversation about the regulation, and more importantly, how it will impact savvy employers looking to leverage more transparency in healthcare pricing. Check it out…..